New research hopes to improve outcomes for Māori with lung disease

7:08 am on 30 July 2021

For the first time, important research will be carried out to study the impact of Chronic Obstructive Pulmonary disease (COPD) amongst Māori.

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The cause of COPD has been linked to smoking cigarettes. Photo: RNZ / Rebekah Parsons-King

More than 500 people who are most at risk of having lung cancer will be tested during a national lung screening trial.

The purpose of the trial will be to test those with higher risk to determine if they have COPD.

COPD is a lung disease which is ranked amongst the top five causes of death in the world and has found to be more common amongst the Māori community then other ethnic groups.

Those carrying out the research trial say this is because COPD has been severely underdiagnosed and undertreated, especially amongst Māori.

University of Otago Professor Dr Sue Crengle is leading the study alongside the Waitematā DHB and the University of Otago.

She said there were rippling impacts for those who had COPD such as higher rates of hospitalisations, respiratory issues and death.

"The impact of COPD among Māori is disproportionate to the rest of the population," Dr Crengle said.

"The disease is known to be underdiagnosed in primary care and there may be under-treatment of diagnosed COPD.

"We see with many of the long-term conditions whether that's COPD, diabetes, heart disease that, in general, Māori don't get the same level of quality of care ... that's what we're trying to address with the project."

Those participating in the trial will take part in low-dose CT scans to detect any abnormalities and, with consent, will be assessed for COPD by blowing into a spirometer device to test their lung capacity, questionnaires, and CT scan results.

Dr Crengle said COPD is often a hidden disease that people do not realise they carry, but it still has severe impacts on their health.

Through the trial research, the aim is to assess who carried the disease in the hopes of making sure it was treated properly by GPs, and outcomes for patients could be improved.

"It's complicated because COPD develops quiet slowly so often people with COPD don't even realise that their symptoms are getting worse," Dr Crengle said.

"The really important thing about it is that if people know that they have COPD, and if GPs know that someone has COPD, then there's really good treatments that can keep people really well and can stop COPD progressing."

The trial will investigate ways to improve the number of diagnoses for the COPD disease and ways to reduce the rate of hospitalisations amongst Māori communities.

Dr Crengle wants to find long-term preventions for combating the disease earlier and achieving better outcomes for Māori.

"What we're really focusing on is how many people have the diagnosis and know they have the diagnosis and how we can improve the treatments and the care that they get for their COPD so they can live their lives well."

"We're really interested in working out how we can support our GPs to identify the COPD and to put treatment that is consistent with the evidence-based guidelines in place," she said.

The cause of COPD has been linked to smoking cigarettes.

But Dr Crengle said the more important issue was that Māori suffered disproportionate impacts from the disease due to it not being diagnosed effectively, and then appropriate treatment not being provided by general health practitioners.

"Early diagnosis is vital to the effective management of this disease - which includes medications, pulmonary rehabilitation programs and support for smoking cessation."

"There's still a higher proportion of Māori who smoke compared to non-Māori, but smoking prevalence is going down and that's a great thing," Dr Crengle said.

She hopes the trial research will lead to better rates of diagnosis and improved treatment of the disease for Māori.

This will coincide with GPs having a greater understanding of how to diagnose the disease and working with Māori communities to reduce hospitalisations and fatalities.

"It will focus on getting people diagnosed and treated sooner to reduce the impact COPD has on the lives of patients and their whānau."

"Anything we can do to improve that will contribute to better outcomes," she said.

Funding for the trial has been given an approved grant of $1.96 million from the Global alliance for global diseases and most recently a second grant of $1.2m from the health research councils Rangahau Hauora Māori investment stream.

The research trial is expected to be underway between September and October.

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